Central or local government?
Care homes used to be run by councils, who paid staff a fair wage for caring for them and they had decent conditions of service. Not like now, when many homes are now running a 2-shift system so staff have to do 12 hour shifts, get the legal minimum leave, pisspoor pensions and about 20p an hour above NMW.
I would merge adult social care and the NHS.
At present, there's a disincentive for ASC to be prompt in carrying out assessments and making provision for people ready to be discharged from hospital. The minute they're discharged ASC has to meet their needs in terms of care, whether it's provided in the community or in a residential setting. The longer the council can delay assessing their needs and making the necessary provision for discharge from hospital, the less it costs them and the more it costs the NHS.
With some people waiting several weeks before they can be discharged from hospital because of delays in assessment and making provision, the cost to the NHS must be significant and it has a knock-on effect on waiting lists because of bed-blocking.
If it was all under one roof, so to speak, I bet that discharge planning and getting care plans in place would be much quicker.